儿童重型流行性乙型脑炎影响因素分析  

Analysis of influencial factors in relation to severe epidemic encephalitis in children

作　　者：陈磊[1] 曾艺[1] 陈先刚[1] 汪强[1] CHEN Lei;ZENG Yi;CHEN Xian-gang;WANG Qiang Yuzhong(District Center for Disease Control and Prevention,Chongqing 400010,China)

机构地区：[1]重庆市渝中区疾病预防控制中心传染病防控科,重庆400010

出　　处：《微生物学免疫学进展》2018年第5期74-79,共6页Progress In Microbiology and Immunology

摘　　要：目的通过对2010—2016年重庆市渝中区儿童重型流行性乙型脑炎(简称乙脑)影响因素的分析,为该地区儿童重型乙脑的防控提供科学依据。方法采用描述性流行病学方法对重庆市渝中区2010—2016年的儿童乙脑患者的基本特征、分型及其差异性、乙脑病情影响因素进行分析。采用SPSS 20.0软件对乙脑发病特征差异性进行统计学分析,用多因素逐步logistic回归分析儿童重型乙脑的影响因素。结果重庆市渝中区在此期间共报告儿童乙脑病例725例,主要为幼托儿童,其中重型344例(47.45%)。人群分布、诊断型别、是否住院、发病前25 d是否有外出史、头痛、精神萎靡、烦躁、意识障碍、抽搐、脑膜刺激征、病理反射肌张力增强等18个因素在非重型组与重型组间差异均有统计学意义(P<0.05);出现惊厥(P<0.000 1,OR:2.876～8.237)、意识障碍(P=0.013,OR:1.109～2.436)、脑膜刺激征(P=0.000 5,OR:1.350～2.963)、病理反射肌张力增强(P=0.000 4,OR:1.377～3.023)的乙脑患儿更易发展为重型乙脑。结论儿童重型乙脑病情重、发展较快,因此临床医生在接诊儿童乙脑患者时应注意观察患者惊厥、意识障碍等症状,避免轻型乙脑患者发展为重型。Objective To analyze influencial factors related to severe epidemic encephalitis type B in children from 2010 to2016 in Yuzhong District in Chongqing City,so as to provide the scientific basis in prevention and control of the disease.Methods The basic characteristics,classification and its diversity of the severe children＇s epidemic encephalitis type B were analyzed by the descriptive epidemiology. SPSS 22.0 software was used in analysis of the statistical difference in basic characteristics on occurrence of the disease,and the related influencial factors were investigated by the multiple stepwise logistic regression. Results A total of 725 cases of children＇s epidemic encephalitis type B were reported,mainly for children in childcare center,with 344 severe cases（ 47.45%）. There were significant differences in different occupation,diagnostic categories hospitalization or not,whether to go out 25 days before the onset,headaches,depression,irritability,disturbance of consciousness and convulsions,meningeal irritation etc,pathological reflex muscle tension,enhanced（ P 0.05） between the mild and severe groups; with the convulsions（ P 〈0.0001,OR： 2.876 ～ 8.237）,disturbance of consciousness（ P = 0.013,OR： 1.109 ～ 2.436）,meningeal stimulation（ P = 0.000 5,OR： 1.350 ～ 2.963） and pathological reflex muscle tension enhanced（ P = 0.000 4,OR： 1.377 ～ 3.023） were more likely to develop to the severe type. Conclusion The severe epidemic encephalitis type B in children was characterized by a serious at the onset and rapidly advance,and the clinicians should pay more attention on symptoms,such as consciousness and convulsions,in avoidance of the moderate case to developing to the severe type.

关 键 词：重型流行性乙型脑炎 logistics回归 影响因素 

分 类 号：R183.1[医药卫生—流行病学] R512.32[医药卫生—公共卫生与预防医学]